Dysfunction of an endocrine gland Secretory cells are unable to produce, obtain, or convert hormone precursors The endocrine gland synthesizes or releases excessive amounts of hormone Increased hormone degradation or inactivation Ectopic hormone release Cell surface receptor-associated disorders Decrease in number of receptors Impaired receptor function Presence of antibodies against specific receptors Antibodies that mimic hormone action Unusual expression of receptor function Intracellular disorders Circulating inhibitors Syndrome of inappropriate antidiuretic hormone secretion (SIADH) Hypersecretion of ADH For diagnosis, normal adrenal and thyroid function must exist Clinical manifestations are related to enhanced renal water retention, hyponatremia, and hypo-osmolality Diabetes insipidus Insufficiency of ADH Polyuria and polydipsia Partial or total inability to concentrate the urine Neurogenic Insufficient amounts of ADH Nephrogenic Inadequate response to ADH Psychogenic Hypopituitarism Pituitary infarction Sheehan syndrome Hemorrhage Shock Others: head trauma, infections, and tumors Hypopituitarism Panhypopituitarism ACTH deficiency TSH deficiency FSH and LH deficiency GH deficiency Hyperpituitarism Commonly caused by a benign slow-growing pituitary adenoma Manifestations Headache and fatigue Visual changes Hyposecretion of neighboring anterior pituitary hormones Hypersecretion of growth hormone (GH) Acromegaly Hypersecretion of GH during adulthood Gigantism Hypersecretion of GH in children and adolescents Hypersecretion of prolactin Caused by prolactinomas In females, increased levels of prolactin cause amenorrhea, galactorrhea, hirsutism, and osteopenia In males, increased levels of prolactin cause hypogonadism, erectile dysfunction, impaired libido, oligospermia, and diminished ejaculate volume Hyperthyroidism Thyrotoxicosis Graves disease Pretibial myxedema Hyperthyroidism resulting from nodular thyroid disease Goiter Thyrotoxic crisis Hyperthyroidism Hypothyroidism Primary hypothyroidism Subacute thyroiditis Autoimmune thyroiditis (Hashimoto disease) Painless thyroiditis Postpartum thyroiditis Myxedema coma Congenital hypothyroidism Thyroid carcinoma Hyperparathyroidism Primary hyperparathyroidism Excess secretion of PTH from one or more parathyroid glands Secondary hyperparathyroidism Increase in PTH secondary to a chronic disease Hypoparathyroidism Abnormally low PTH levels Usually caused by parathyroid damage in thyroid surgery Demonstrates pancreatic atrophy and specific loss of beta cells Macrophages, T- and B-lymphocytes, and natural killer cells are present Two types Immune Nonimmune Genetic susceptibility Environmental factors Immunologically mediated destruction of beta cells Manifestations Hyperglycemia, polydipsia, polyuria, polyphagia, weight loss, and fatigue Type 2 diabetes mellitus Maturity-onset diabetes of youth (MODY) Gestational diabetes mellitus (GDM) Common form of diabetes mellitus type 2 Insulin resistance Hypoglycemia Diabetic ketoacidosis Hyperosmolar hyperglycemic nonketotic syndrome (HHNKS) Somogyi effect Dawn phenomenon Hyperglycemia and nonenzymatic glycosylation Hyperglycemia and the polyol pathway Protein kinase C Microvascular disease Retinopathy Diabetic nephropathy Macrovascular disease Coronary artery disease Stroke Peripheral arterial disease Diabetic neuropathies Infection Disorders of the adrenal cortex Cushing disease Excessive anterior pituitary secretion of ACTH Cushing syndrome Excessive level of cortisol, regardless of cause Disorders of the adrenal cortex Hyperaldosteronism Primary hyperaldosteronism (Conn disease) Secondary hyperaldosteronism Disorders of the adrenal cortex Adrenocortical hypofunction Primary adrenal insufficiency (Addison disease) Idiopathic Addison disease Secondary hypocortisolism Disorders of the adrenal cortex Hypersecretion of adrenal androgens and estrogens Feminization Virilization Disorders of the adrenal medulla Adrenal medulla hyperfunction Caused by tumors derived from the chromaffin cells of the adrenal medulla Pheochromocytomas Secrete catecholamines on a continuous or episodic basis